Non-invited review: prevention of microvascular diabetic complications by fenofibrate: lessons from FIELD and ACCORD

Diab Vasc Dis Res. 2011 Jul;8(3):180-9. doi: 10.1177/1479164111407783. Epub 2011 May 16.


Microvascular complications are common in type 2 diabetes in primary care. Intensified management of glycaemia or blood pressure had little effect on microvascular complication rates in recent large trials (ADVANCE, VADT, ACCORD). In 2005, the FIELD study demonstrated a significant reduction in the need for laser treatment for retinopathy, and of progression of renal dysfunction, with fenofibrate versus placebo. The FIELD ophthalmology sub-study showed that fenofibrate reduced the risk of new retinopathy and progression of retinopathy. Also, fenofibrate versus placebo significantly reduced the risk of non-traumatic, diabetes-related amputations in a post-hoc analysis from FIELD. Recently, the results of the ACCORD Lipid study were consistent with these findings, as fenofibrate significantly reduced progression of retinopathy and albuminuria, apparently independent of effects on lipids. These findings suggest a role for fenofibrate in the prevention of major diabetic microvascular complications.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Albuminuria / etiology
  • Albuminuria / prevention & control
  • Diabetes Mellitus, Type 1 / complications
  • Diabetes Mellitus, Type 1 / drug therapy*
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetic Retinopathy / etiology
  • Diabetic Retinopathy / physiopathology
  • Diabetic Retinopathy / prevention & control*
  • Evidence-Based Medicine
  • Fenofibrate / therapeutic use*
  • Humans
  • Lower Extremity / blood supply*
  • Microvessels / drug effects*
  • Microvessels / physiopathology
  • Peripheral Arterial Disease / etiology
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / prevention & control*
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Fenofibrate